The Role of the Endometrium (The Uterine Lining) in Fertility

A thick, healthy lining of the uterus, known as the endometrium is necessary for a healthy menstrual cycle and pregnancy. A fertilised egg needs the lining of the uterus to have a certain thickness to implant and begin growing. A thin endometrium that exists in some patients is the leading cause of infertility or recurrent miscarriage. It is one of the factors responsible for early implantation defect in In-vitro fertilisation treatment. What should you do if your endometrial lining is thin? I will attempt in this article to discuss the causes of the thin endometrial lining, what natural things you can do to help your endometrial lining if it is light and the various medical therapies available. It is for you to learn how to build and protect a thick, healthy uterine lining naturally. There are many natural therapies that can help to increase the thickness and health of the uterine lining.  

Many scholars describe the endometrium as the layer of the uterus that thickens in preparation for the implantation of the fertilised embryo. The endometrium is also the layer that sheds during menstruation. Oestrogen is responsible for creating a thick, lush, and blood-rich endometrium. If  oestrogen levels are not adequate, the uterine lining will remain thin. A healthy, appropriate uterine lining is, at least, 8mm thick. Below that, doctors consider it inadequate to support embryo implantation.    What are the causes of a thin uterine lining?  

There are five leading causes of a thin uterine lining. In our environment, in term of priority, they are:  

Poor health of the endometrial tissue: Damage from infection, surgery or illness may cause damage to the tissues of the endometrium. This damage may also compromise blood flow to the endometrium, as well as how the endometrium functions. Dilation and Curettage  

D&C performed incorrectly by may cause the removal of the basalis layer of the endometrium. Once this layer is gone, the endometrium cannot grow, the results of which is a variant of Ashermans syndrome. Women who have had a D&C have a 25 per cent risk of developing ashermans two to four weeks post-procedure. D&C performed for missed miscarriage have a 30.9 per cent chance of developing ashermans, whereas women who have had a D&C due to an incomplete miscarriage only have a 6.4 per cent chance of developing ashermans. Women who have had more than 2 D&C’s have an increased chance of developing ashermans by 32 per cent. About 90 per cent of all Ashermans cases are due to the D&C procedure.  

In Nigeria, asherman’s syndrome is now widespread compared to the rest of the world. The recent studies of Yakasai and his team at the Aminu Kano Teaching Hospital and Asuquo in Uyo Teaching Hospital confirmed this observation. It is due to the prevalence of fibroid, leading to myomectomy and other related issues. In another study, 40 per cent of patients who underwent repeated D&C for retained products of conception after missed miscarriage or retained placenta developed ashermans syndrome  

In the case of missed miscarriages, the period between fetal demise and curettage may increase the likelihood of adhesion formation due to the fibroblastic activity of the remaining tissue.  

Scar Tissue and Adhesion Damage  

Scar tissue damage to the endometrium, with adhesions within the uterine cavity is known as ashermans syndrome. There are different grades of severity. This type of injury can be a direct result of one of or a combination of the following:  

Reproductive organ surgery; laparoscopy, cesarean section Pelvic Inflammatory Disease D&C Genital Tuberculosis Induced medical abortion   Infection and Pelvic Inflammatory Disease   Recurrent bacterial infections, sexually transmitted disease or damage to the uterus may cause PID or pelvic inflammatory disease. The constant state of infection and inflammation can cause damage to the tissues and may result in scar tissue formation of the endometrium. When this happens, the endometrium may not be able to function as it should.  

Low Oestrogen  

For the endometrium to thicken, it is reliant on adequate levels of oestrogen. The entire menstrual cycle is dependent on sufficient levels of estrogen. Women with absent periods known as amenorrhea often have a thin uterine lining due to low levels of hormones.  

The most common cause of low estrogen is perimenopause and menopause. It is entirely reasonable as hormone levels begin to decline as a woman ages. It can become a problematic and compromising situation if you are trying for a baby, and it is not as common for women in their 20’s and 30’s, but more common in women over the age of 40.